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General NPI Number Information
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NPI Number | 1629421136
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Entity Type | Individual
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Provider Name | JULIANA DEMERGIS D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/20/2016
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Last Update Date | 12/21/2024
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Provider Practice Location Address
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Address Line | 509 S LENOLA RD BLDG 4
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City | MOORESTOWN
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State | NJ
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Zip | 08057-1561
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Country | US
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Telephone | 856-242-2111
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Fax |
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Provider Business Mailing Address
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Address Line | 24 ROLLING GLEN CT
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City | MOUNT LAUREL
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State | NJ
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Zip | 08054-9500
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DS042789
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 22DI02870900
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License Number State | NJ
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